Table 2

Overarching principles and points to consider for the assessment of competences in rheumatology specialty training, with LoA and for the specific points, levels of evidence

Overarching principlesLoA, mean (SD)
1. Rheumatology training should generate rheumatologists capable and committed to deliver the best of care to people with rheumatic and musculoskeletal diseases.9.9 (0.45),
100%≥8
2. Assessment as an integral part of training must be guided by and aligned with a clear set of educational objectives established by an official/national/accepted curriculum.9.8 (0.52),
100%≥8
3. Assessment of competences is vital to guide learning and to guarantee quality of care.9.8 (0.41),
100%≥8
4. Effective assessment requires protected time and resources.9.7 (0.73),
95%≥8
Points to consider LoE LoA, mean (SD)
1. Assessment of competences should be a structured and continuous process regularly carried out throughout the training period.59.75 (0.55),
100%≥8
2. Formative assessment with constructive feedback should be frequently performed and with a greater frequency than summative assessment.59.4 (0.82),
100%≥8
3. Feedback should aim to stimulate reflections by the trainee on how to achieve standards of competence and professional behaviour.59.65 (0.67),
100%≥8
4. Trainees should maintain an updated portfolio, including feedback and evidence of self-reflection, to be used as part of the assessment process.59.4 (0.75),
100%≥8
5. Different methods of assessment should be carried out throughout training as multiple methods of assessment can provide a complete overview of a trainee’s competence.59.75 (0.64),
100%≥8
6. Multiple-choice case-based questions should be the preferred form of knowledge assessment.58.75 (1.83),
75%≥8
7. Clinical skills should be assessed either in the workplace (direct observation of procedural skills or the mini-clinical examination exercise) and/or in a simulated context (observational structured clinical examination)59.35 (0.81),
100%≥8
8. Competences related to professionalism should be formally assessed using multisource feedback/360° method.59.25 (0.97),
95%≥8
9. The training programme should incorporate predefined processes to identify and support trainees at risk of failure.59.6 (0.75),
100%≥8
10. Trainers should receive continuous training in assessment methods and strategies, particularly in providing constructive feedback.59.4 (1.23),
95%≥8

  • Numbers in the column ‘LoA’ indicate the mean (SD) of the LoA and the percentage of task force members with an LoA of at least 8 (0–10). LoE: based on the Oxford Centre for Evidence-Based Medicine classification, with ‘level 1’ corresponding to meta-analysis or RCTs or high-quality RCTs; ‘level 2’ corresponding to lesser quality RCTs or prospective comparative studies; ‘level 3’ corresponding to case–control studies or retrospective studies; ‘level 4’ corresponding to case series without the use of comparison or control groups; and ‘level 5’ corresponding to case reports or expert opinion.11

  • LoA, level of agreement; LoE, level of evidence; RCT, randomised controlled trial.